Testing Digital Methods of Patient-Reported Outcomes Data Collection: A prospective, cluster randomized trial to test text messaging and mobile surveys. (Preprint)

BACKGROUND The growth of mobile and digital health data collection continues to accelerate in healthcare. Patient-reported outcomes are those data points collected from patients and there is a growing body of work to use mobile and digital methods to generate these data. Multiple methods exist in using technology to gather data with mobile surveys and text messaging. There remains a gap in evaluating these methods in prospective, randomized studies. OBJECTIVE To prospectively investigate two common methods of remote patient-reported outcomes data collection. The study sought to analyze response and engagement rates through two modalities including bi-directional text messaging or mobile surveys. METHODS Prospective, block randomized trial of adult patients undergoing elective sports medicine and orthopedic procedures over 6 weeks. The primary objective was to determine if the method of digital patient engagement would impact response and completion rates. The primary outcome was response rate and total competition of patient reported outcomes questionnaires. RESULTS 127 participants were block randomized into either receiving a mobile survey (n=63) delivered as a hyperlink or were asked the same questions through an automated conversational text messaging (n=64). Gender, age, number of comorbidities, number of opioid tablets prescribed were similar across messaging arms. Overall engagement over the immediate post-operative was similar between the messaging arms. Prolonged engagement past post-operative day 4 was higher in the mobile survey arm at day 7 (95% vs. 56%). Patients with more invasive procedures showed a trend toward being responsive at day 4 as compared to non-responders. CONCLUSIONS As digital platforms become more commonly used in health care, testing the various options to engage patients to gather data is crucial to inform future care and research. We found that globally bi-directional text messaging and mobile surveys were comparable in response and engagement rates, however mobile surveys may trend toward higher response rates over longer periods of time.